Maintaining and recovering soft tissue health around dental implants: a Cochrane systematic review of randomised controlled clinical trials.
ABSTRACT To evaluate which are the most effective procedures to maintain and recover soft tissue health around dental implants.
The Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE and EMBASE were searched with no language restriction up to June 2007. Handsearching included several dental journals, the bibliographies of the randomised controlled trials (RCTs) and relevant review articles.
RCTs comparing agents or interventions for maintaining or recovering peri-implant healthy tissues were eligible. Outcome measures were: implant failure, radiographic marginal bone level changes, changes in probing 'attachment' level, changes in probing pocket depth, marginal bleeding, plaque, side effects, ease of maintenance, patient satisfaction, cost, and treatment time. Screening of eligible studies, quality assessment and data extraction were conducted in duplicate. Authors were contacted for missing information. Results were expressed as random effect models using standardised mean differences for continuous data and relative risks for dichotomous data with 95% confidence intervals.
Eighteen RCTs were identified. Nine (238 patients) were included. Follow-ups ranged between 6 weeks and 1 year. No meta-analysis could be made since all trials tested different interventions. Listerine mouthwash showed a reduction of 54% in plaque and 34% in marginal bleeding compared with a placebo after 3 months.
There was little reliable evidence for which are the most effective interventions for maintaining healthy peri-implant soft tissues. However, it should not be interpreted that current maintenance regimens are ineffective. There is a definite need for trials powered to find possible differences, using primary outcome measures and with much longer follow-up.
- SourceAvailable from: Mizuho A KidoImplant Dentistry - The Most Promising Discipline of Dentistry, 09/2011; , ISBN: 978-953-307-481-8
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ABSTRACT: The health of peri-implant soft tissues is one of the most important aspects of osseointegration necessary for the long-term survival of dental implants. To review the process of soft tissue healing around osseointegrated implants and discuss the maintenance requirements as well as the possible short-comings of peri-implant soft tissue integration. Literature search on the process involved in osseointegration, soft tissue healing and currently available treatment modalities was performed and a brief description of each process was provided. The peri-implant interface has been shown to be less effective than natural teeth in resisting bacterial invasion because gingival fiber alignment and reduced vascular supply make it more vulnerable to subsequent peri-implant disease and future bone loss around implants. And we summarized common procedures which have been shown to be effective in preventing peri-implantitis disease progression as well as clinical techniques utilized to regenerate soft tissues with bone loss in advanced cases of peri-implantitis. Due to the difference between peri-implant interface and natural teeth, clinicians and patients should pay more attention in the maintenance and recovery of soft tissues around implants. © 2015 Wiley Periodicals, Inc.Clinical Implant Dentistry and Related Research 04/2015; DOI:10.1111/cid.12343 · 2.80 Impact Factor
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ABSTRACT: Objective: The biologic seal of peri-implant soft tissue is crucial for long-term prognosis of oral implants. This in vitro study describes a novel tissue culture model using porcine gingival explants to evaluate the soft tissue/implant interface. Method: Two different types of substrates were investigated: (a) Plain polymer: BisGMA-TEGDMA (50%–50%) and (b) Unidirectional E-glass fiber-reinforced composite (FRC). Porcine gingival explants were obtained from a local slaughterhouse. The experimental implants (n=4) were inserted into the middle of freshly excised porcine gingival explants and cultured at the air/liquid interface up to 14 days. Porcine gingival explants with no implants served as baseline controls. The specimens were fixed and processed for the preparation of undecalcified samples. Histological analysis of the soft tissue/implant interface was carried out using a light-microscope. Result: Microscopic evaluation suggests that gingival epithelium and connective tissue established an immediate close contact with both plain polymer and FRC implants. However, FRC sufraces seemed to guide epithelial migration outwards from the tissue/implant interface. Conclusion: This in vitro model maintains mucosal viability and ability to histologically evaluate soft tissue attachment to biomaterials rendering it a time efficient and cost effective model that may reduce the need for animal experiments.IADR General Session and Exhibition 2014; 06/2014